Second Generation" Drug-Eluting Stents Implantation Followed by Six Versus Twelve-Month - Dual Antiplatelet Therapy

Fondazione Evidence per Attività e Ricerche Cardiovascolari ONLUS

Status and phase

Terminated

Phase 3

Conditions

Angina Pectoris

Silent Ischemia

Treatments

Drug: Clopidogrel

Study type

Interventional

Funder types

Other

Identifiers

NCT00944333

Security

Details and patient eligibility

About

Prospective, randomized, non-inferiority, multicenter, international study.In total 4000 patients (70 centers in Europe) with de novo lesions in native coronary arteries who meet the eligibility criteria randomized to 6 versus 12 month dual antiplatelet therapies following a second generation DES implantation.

Assuming that the true proportion of thrombotic events is equal to 2.3% for both regimens (6-month and 12-month clopidogrel) 2000 patients for each treatment group are necessary to demonstrate a non-inferiority of the 6-months regimen if the proportion of thrombotic events will be no more than 3.5% with a power of 0.80 and a significance level of 0.05 (one-tail).

If the non-inferiority hypothesis will be rejected, the superiority hypothesis (12-months regimen is superior to the 6-months-regimen) will be tested at a significance level of 0.05 (two-tails).

The maximal not clinically relevant difference for the non-inferiority hypothesis of 1.2 % more thrombotic events has to be considered together with the lower expected number of bleeding events in the 6-months regimen.

All the analysis will be done as "intention-to-treat" analysis.

Enrollment

1,378 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Diagnosis of angina pectoris as defined by Canadian Cardiovascular Society Classification (CCS I,II, III, IV) OR unstable angina pectoris (Braunwald Classification B&C, I-II-III) OR patients with documented silent ischemia, all treated with a second generation drug eluting stent
Presence of one or more de novo stenosis equal or greater than 70% in a native coronary artery, treated with a Resolute drug eluting stent
Patient is > 18 years of age (or minimum age as required by local regulations).
The patient has consented to participate by signing the "Patient Informed Consent Form""
The patient is willing and able to cooperate with study procedures and required follow up visits
Any type of lesion or number of lesion can be included in this trial unless specifically detailed in the exclusion criteria.
At least one second generation DES implanted in the target lesion in the last 24 hours
No other DES implanted before the target procedure
No BMS implanted in the 12 months before the target procedure

Exclusion criteria

Patients treated for lesions in venous or arterial grafts
Patients treated for in-stent restenosis
Patients treated for Unprotected Left Main lesions
ST elevation myocardial infarction in the 48 hours prior to the procedure
Non ST elevation myocardial infarction
Patients with LVEF≤30%
Women with known pregnancy or who are lactating
Patients with hypersensitivity or allergies to hepari, or any other analogue or derivative, cobalt, chromium, nickel, molybdenum or contrast media.
Patients with chronic renal insufficiency
Contraindication to the use of clopidogrel and/or ASA:
- History of drug allergy to thienopyridine derivatives or ASA
- History of clinically significant or persistent thrombocytopenia or neutropenia
- Active bleeding or significant risk of bleeding, such as elderly patients receining fibrinolytic therapy and other potent antithrombotic agents, severe hepatic insufficiency, current peptic ulceration, proliferative diabetic retinopathy
- Uncontrolled hypertension
Current medical condition with a life expectancy of less than 24 months.
The subject is participating in another device or drug study
Subject must have completed the follow-up phase of any previous study at least 30 days prior to enrolment in this trial.
Patients with medical conditions that preclude the follow-up as defined in the protocol or that otherwise limits participation in this study